EP1613372B1 - Gerät für die plasmareinigung in kombination mit plasmaadsorption-perfusion durch verwendung eines trikompartiment-dialysators - Google Patents

Gerät für die plasmareinigung in kombination mit plasmaadsorption-perfusion durch verwendung eines trikompartiment-dialysators Download PDF

Info

Publication number
EP1613372B1
EP1613372B1 EP04726449A EP04726449A EP1613372B1 EP 1613372 B1 EP1613372 B1 EP 1613372B1 EP 04726449 A EP04726449 A EP 04726449A EP 04726449 A EP04726449 A EP 04726449A EP 1613372 B1 EP1613372 B1 EP 1613372B1
Authority
EP
European Patent Office
Prior art keywords
plasma
whole blood
purification
stage
blood
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP04726449A
Other languages
English (en)
French (fr)
Other versions
EP1613372A1 (de
Inventor
Federico Nalesso
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of EP1613372A1 publication Critical patent/EP1613372A1/de
Application granted granted Critical
Publication of EP1613372B1 publication Critical patent/EP1613372B1/de
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/3496—Plasmapheresis; Leucopheresis; Lymphopheresis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/342—Adding solutions to the blood, e.g. substitution solutions
    • A61M1/3455—Substitution fluids
    • A61M1/3468—Substitution fluids using treated filtrate as substitution fluid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/3472—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration with treatment of the filtrate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/3472—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration with treatment of the filtrate
    • A61M1/3479—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration with treatment of the filtrate by dialysing the filtrate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/3472—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration with treatment of the filtrate
    • A61M1/3486—Biological, chemical treatment, e.g. chemical precipitation; treatment by absorbents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
    • A61M1/1694—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes with recirculating dialysing liquid
    • A61M1/1696—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes with recirculating dialysing liquid with dialysate regeneration

Definitions

  • the present invention relates to a machine for plasma purification combined with plasma adsorption-perfusion by using a tricompartmental dialyzer.
  • Systemic infections also known as sepses, caused by massive and persistent invasion of the circulatory torrent by pathogenic microorganisms or by toxins produced by such microorganisms, and septic shock are among the leading causes of mortality in intensive-care situations.
  • the various elements that seem to take part in the development of the multiple-organ dysfunction in patients in intensive care include circulating peptic substances, inflammation mediators, cytokines, bacterial products, endotoxin and other molecules.
  • Circulating inflammation mediators that have entered the bloodstream from inflammation sites are considered responsible for remote tissue damage and are seen as decisive factors in the multiple-organ dysfunction observed in sepsis.
  • liver failure Another extremely important clinical problem relates to patients affected by liver failure, who inexorably, as the pathology progresses, develop kidney failure (hepatorenal syndrome) and all the complications caused by retention of liver toxins.
  • kidney failure hepatorenal syndrome
  • albumin-bound toxins The accumulation of albumin-bound toxins has been demonstrated during liver failure; these toxins are responsible, to variable extents, for multiple-organ dysfunction (kidney, cardiovascular instability, et cetera).
  • albumin for transport and as a possible purification vector have been described in albumin dialysis, in which the removal of these molecules improves the clinical condition of the patient.
  • MARS Molecular Adsorbents Recycling System
  • albumin that is heterologous with respect to the patient to perform purification by adsorption and by classic dialysis.
  • the aim of the present invention is to provide a blood purification device that allows to eliminate from blood all the elements that cause in patients sepsis, septic shock, multiple-organ dysfunctions, problems related to hepatorenal syndromes, et cetera.
  • an object of the present invention is to provide a blood purification device that allows to group and utilize in the same treatment all currently known physical and chemical principles for purifying the blood of the patient.
  • Another object of the present invention is to provide a blood purification device that can be interfaced easily even with known dialysis devices or blood purification devices.
  • Another object of the present invention is to provide a blood purification device that is compact.
  • Another object of the present invention is to provide a blood purification device that can be manufactured with known systems and technologies.
  • a blood purification device according to the invention is generally designated by the reference numeral 10.
  • the device 10 comprises, in this described embodiment, a filter 12, of the type for hemodialysis or the like, which is constituted by an internal compartment 13 that is crossed by parallel permeable capillaries 14, of a per se known type, which are made for example of synthetic and biocompatible material such as EVAL (ethylene-vinyl-alcohol) or polypropylene (or similar materials).
  • EVAL ethylene-vinyl-alcohol
  • polypropylene or similar materials
  • the internal compartment 13 is divided, along the extension of the capillaries 14, into two compartments separated by a wall 13a, respectively a first compartment 18, which forms a stage 19 for filtering plasma from whole blood, and a second compartment 20, which forms a stage 21 for dialysis of whole blood by means of purified plasma, which flows in countercurrent with respect to the whole blood.
  • the stage 21 for dialyzing blood by means of purified plasma comprises a selectively permeable interface, which separates the whole blood stream of the duct 17 from a countercurrent stream of purified plasma that arrives from a plasma purification circuit 23, which is described in greater detail hereinafter.
  • such selectively permeable interface is constituted by the capillaries 14 that are present in the second compartment 20.
  • the first and second compartments 18 and 20 are mutually connected at the region where the countercurrent flow of the purified plasma ends.
  • connection is provided by means of a hole 24 formed in the wall 13a that separates the two compartments 18 and 20.
  • the first compartment 18 forms the stage 19 for filtering plasma from the whole blood.
  • the stage 19 for filtering plasma from whole blood is per se of a known type.
  • the first compartment is functionally connected in output to the plasma purification circuit 23; such circuit in turn is functionally connected in output downstream of the stage 19 for filtering plasma from whole blood and the stage 21 for dialyzing whole blood by means of purified plasma.
  • the plasma purification circuit 23 comprises, for example, a device 25 for removing water-soluble and dialyzable toxic molecules of a per se known type, generally used for blood purification but used in this case in an original manner to purify plasma that arrives from the stage 19 for filtering plasma from whole blood 19.
  • the device 25 for removing water-soluble and dialyzable toxic molecules is composed of modules that perform diffusive processes such as high-flux dialysis (although the expression "high-flux plasma dialysis” would be more correct, since it is applied to the plasma, not to the blood), convective-diffusive processes such as hemofiltration or high-volume hemofiltration (likewise, plasma filtration and high-volume plasma filtration), processes for adsorption on a membrane (which are present, at least to a minimum extent, in all the previously cited processes).
  • diffusive processes such as high-flux dialysis (although the expression "high-flux plasma dialysis” would be more correct, since it is applied to the plasma, not to the blood), convective-diffusive processes such as hemofiltration or high-volume hemofiltration (likewise, plasma filtration and high-volume plasma filtration), processes for adsorption on a membrane (which are present, at least to a minimum extent, in all the previously cited processes).
  • the device 25 for removing water-soluble and dialyzable toxic molecules comprises a dialyzer 26 that is functionally connected to a dialysate tank 27, a tank for the used dialysate 28, and an infusate tank 29.
  • the plasma purification circuit 23 comprises, in series to the device 25 for removing water-soluble and dialyzable toxic molecules, a purification module of the adsorptive and/or perfusive type 30, of a per se known type, used for the purification of plasma that arrives from the device 25 for removing water-soluble and dialyzable toxic molecules.
  • the purification module of the adsorptive and/or perfusive type 30 comprises one or more adsorptive columns and/or one or more perfusive columns on carbon.
  • a hydraulic pump 31 for example of the peristaltic type.
  • hydraulic pumps 32 preferably of the peristaltic type, in a number and arrangement that is convenient for the particular use of the circuit.
  • the whole blood is drawn from the patient by means of a central venous access for hemodialysis or arteriovenous fistula and by means of the propelling force of the peristaltic pump 31 is circulated in the duct 17 for the flow of the whole blood with a flux that can vary depending on whether the device is operating in a continuous or intermittent purification mode.
  • the plasma obtained by filtration from the whole blood in the stage 19 for filtering plasma from whole blood, is propelled, again by a peristaltic pump, into the plasma purification circuit 23, where it is subjected to a first purification process by performing, in the device 25 for removing water-soluble or dialyzable toxic molecules, a diffusive or convective-diffusive or pure convective method as described above.
  • the choice of the method performed depends on the conditions of the patient, on the degree of purification efficiency that one wishes to obtain, and therefore on the types of molecule that one wishes to eliminate.
  • the first method has the goal of removing all water-soluble and dialyzable molecules by way of the membrane used in the dialyzer 26 by means of a diffusive or diffusive-convective or pure convective process and, to a small extent, by means of an adsorptive process performed on the surface of said membrane.
  • the plasma advances through the adsorptive and/or perfusive purification module 30, such as a specific column chosen according to clinical requirements, where it is subjected to an adsorption-perfusion process that allows to remove the molecules bound to plasma albumin or to other plasma components and the molecules that cannot be removed by means of the first purification method performed in the device 25 for removing water-soluble or dialyzable toxic molecules;
  • the column can be preceded or not by a carbon column in order to increase purification.
  • the effectiveness of molecule removal depends on the selectivity of the material used in the column.
  • This adsorptive process is capable of increasing the purification effectiveness of the first treatment and in any case benefits from the first treatment in performing a higher purification with respect to molecules that are scarcely or minimally removable with diffusive or convective process, even in combination.
  • the choice of high-flux dialysis allows to remove the direct bilirubin from the plasma, allowing the specific column (adsorptive-perfusive process) to remove with a higher specificity the indirect bilirubin (which is more toxic), since it has to work on a plasma that has a reduced content of direct bilirubin, which in any case reduces the adsorption of indirect bilirubin (purification synergism of the two methods used simultaneously).
  • the plasma advances along two distinct and separate paths.
  • One fraction returns to the patient through the venous line (branch 23a of the circuit 23 that branches out from a common expander 23b, of a known type, which ensures continuity of flow), and the other fraction is directed, again under the control of a peristaltic pump, into the stage 21 for dialyzing the whole blood by means of purified plasma (second compartment 20), where by flowing in countercurrent with respect to the whole blood that is present in the capillaries 14 it acts as a dialysate and performs a selective removal of the molecules bound to plasma albumin and to the other plasma components of the whole blood contained in some of the capillaries 14 (and therefore in part of the flow duct 17), or in any case of all the molecules that can be captured by said albumin due to bond affinity.
  • the plasma loaded with toxins passes, through the hole 24, into the first compartment 18, where it joins the plasma filtered in the stage 19 for filtering plasma from whole blood, and is returned to the plasma purification circuit 23, where it undergoes the same sequential purification described earlier.
  • the fraction of purified plasma that returns to the patient is capable of increasing the binding capacity of the plasma with respect to all toxic factors that have binding affinity with albumin and with the other plasma components; in this manner, the plasma is capable of capturing the toxic factors that are present in the tissues and of conveying them to the dialyzer, where they are partly removed by the process of dialysis with regenerated plasma and partly removed by the purification processes performed on the plasma filtered from the whole blood.
  • the arrow (a) designates the blood that flows in the permeable capillaries (shown in Figures 2 and 3 ).
  • the arrow (b1) designates the purified plasma that arrives from the circuit 23 that enters the second compartment 20; the arrow (b2) designates the plasma that, in countercurrent, purifies the whole blood of the capillaries (acts as a dialysate), the arrow (b3) designates the plasma which, once the capillary blood (which as such is therefore "dirty") has been purified, passes into the first compartment 18, joining the plasma filtered by the capillaries that are present in said compartment; the arrow (b4) designates the "dirty” plasma mixed with the filtered plasma; the arrow (b5) designates the "dirty” plasma in output from the filter 12 in order to enter the plasma purification circuit 23.
  • the arrow (c1) designates the plasma filtered by the capillaries, and the arrow (c2) designates the filtered plasma, which together with the "dirty" plasma enters the plasma purification circuit 23.
  • the plasma of the patient therefore becomes the vector of toxic factors, which can be removed from the tissues by utilizing the binding capacity of plasma albumin and high plasma components, and the capacity of plasma water to convey water-soluble molecules.
  • Tissue toxic factors are captured by the plasma and entrained in the bloodstream; the invention extracts the toxic factors from the bloodstream (plasma) by means of the adsorptive-perfusive purification process, from the plasma water by means of the diffusive, convective or diffusive-convective process, and from the whole blood by means of dialysis with regenerated plasma.
  • the processes performed in the device 25 for removing water-soluble and dialyzable toxic molecules of the plasma purification circuit are specific for molecules that are water-soluble molecules and therefore are dissolved in the plasma water; if these processes, in addition to being diffusive, also use convection, there is a distinct increase in the removal of the molecules that have a higher molecular weight and are therefore less dialyzable by diffusion.
  • the processes performed in the adsorptive and/or perfusive purification module 30 allow to remove plasma albumin-bound molecules (bilirubin, skatoles, phenols, endogenous benzodiazepines, et cetera), molecules of high molecular weight which as such cannot be dialyzed (such as for example certain cytokines), and scarcely water-soluble molecules, which as such cannot be diffused by means of the plasma water.
  • plasma albumin-bound molecules bilirubin, skatoles, phenols, endogenous benzodiazepines, et cetera
  • molecules of high molecular weight which as such cannot be dialyzed (such as for example certain cytokines)
  • scarcely water-soluble molecules which as such cannot be diffused by means of the plasma water.
  • the versatility of association among the various processes performed in the device 25 for removing water-soluble and dialyzable toxic molecules and the adsorptive-perfusive process allow to obtain and perform the best treatment for the set goals (removal of cytokines in a septic patient, removal of uremic and hepatic toxins during hepatorenal syndrome, removal of bilirubin, bile acids, ammonium, skatoles, phenols, indoles, endogenous benzodiazepines during liver failure, support for patients with multiple-organ dysfunction or failure syndrome, et cetera).
  • the machine can act as an intermittent treatment on demand or as a continuous therapy for support of particularly unstable patients (hepatorenal syndrome with encephalopathy, septic shock) held in intensive-care units.
  • the versatility of this machine also allows to provide continuous diffusive, convective and diffusive-convective treatments (CRRT: Continuous Renal Replacement Therapies) on whole blood.
  • CRRT Continuous Renal Replacement Therapies
  • the specific adsorption column selected for the treatment can be used or not on the whole blood depending on its biocompatibility and on the required purification.
  • the machine uses the plasma purification circuit for the whole blood and the device 25 for removing water-soluble and dialyzable toxic molecules is used on the whole blood.
  • stage 19 for filtering plasma from whole blood and the stage 21 for dialyzing the whole blood by means of purified plasma can be provided in separate devices that are not grouped in a single hemodialysis filter (so as to form in practice a single tricompartmental dialyzer) and are divided into two compartments by a wall, as briefly described hereinafter (no figures are attached because the concept is extremely intuitive and equivalent to the structure of the purification device described above).
  • the stage for filtering plasma from whole blood can comprise a filter, such as a filter for plasmapheresis or the like, while the stage for dialyzing the whole blood by means of purified plasma is constituted by a compartment that is independent and completely separate from the plasmapheresis filter and is crossed by permeable parallel capillaries that delimit part of the duct where the whole blood flows.
  • a filter such as a filter for plasmapheresis or the like
  • the stage for dialyzing the whole blood by means of purified plasma is constituted by a compartment that is independent and completely separate from the plasmapheresis filter and is crossed by permeable parallel capillaries that delimit part of the duct where the whole blood flows.
  • the purified plasma flows in countercurrent within the compartment.
  • the compartment is functionally connected, by means of a tube, to the filter in the region where the countercurrent flow of the purified plasma ends; the region and the compartment are functionally connected by means of tubes respectively to an inlet and an outlet of the plasma purification circuit.
  • the materials employed may be any according to requirements and to the state of the art.

Landscapes

  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Vascular Medicine (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Molecular Biology (AREA)
  • Cell Biology (AREA)
  • Biodiversity & Conservation Biology (AREA)
  • External Artificial Organs (AREA)
  • Separation Using Semi-Permeable Membranes (AREA)

Claims (7)

  1. Ein Gerät zur Plasmareinigung, enthaltend einen Leitungskanal (17) für den Fluss des Gesamtblutes, entlang dessen sich eine Apparatur (19) zur Plasmafiltration aus dem Gesamtblut befindet, die funktionell in Verbindung zu einem Plasmareinigungskreislauf (23) geregelt werden kann, und entlang dessen sich eine Apparatur (21) zur Dialyse des Gesamtblutes durch Plasma, das in besagtem Plasmareinigungskreislauf (23) gereinigt wurde, befindet, die besagte Apparatur (21) zur Gesamtblutdialyse enthaltend eine selektiv permeable Grenzfläche zur Abtrennung von zumindest einem Teil des Gesamtblutstroms durch besagten Leitungskanal (17) von einem Gegenströmungsfluss des in besagtem Plasmareinigungskreislauf (23) gereinigten Plasmas, das Gerät weiterhin einen Filter (12) enthaltend, der aus einer inneren Kammer (13) besteht, die von parallelen permeablen Kapillaren (14) gekreuzt wird, um die selektiv permeable Grenzfläche zu bilden, und wobei der Raum innerhalb dieser Kapillaren (14) zumindest einen Teil des besagten Leitungskanals (17) beim Fluss besagten Gesamtbluts begrenzt, dadurch gekennzeichnet, dass diese innere Kammer (13) entlang der Ausrichtung besagter Kapillaren (14) in zwei getrennte Kammern (18,20) unterteilt ist, wovon die erste Kammer (18) die besagte Apparatur (19) zur Plasmafiltration aus dem Gesamtblut bildet und die zweite Kammer (20) die besagte Apparatur (21) zur Dialyse des Gesamtbluts durch gereinigtes Plasma im Gegenstrom zum Gesamtblut bildet, wobei besagte erste und zweite Kammer (18, 20) in dem Bereich miteinander verbunden sind, an dem der Gegenströmungsfluss besagten gereinigten Plasmas endet, und wobei besagte erste und zweite Kammer (18, 20) zudem funktionell regelbar miteinander verbunden sind hinsichtlich des jeweiligen Inputs oder Outputs besagten Plasmareinigungskreislaufs (23).
  2. Das Gerät zur Plasmareinigung gemäß Anspruch 1, dadurch gekennzeichnet, dass es einen Plasmareinigungskreislauf (23), der durch besagte Apparatur (19) zur Plasmafiltration aus dem Gesamtblut filtriert wurde, umfasst, der mit besagter Apparatur (21) zur Dialyse des Gesamtbluts durch gereinigtes Plasma funktionell verbunden ist, wobei besagter Plasmareinigungskreislauf (23) strömungsabwärts sowohl besagter Apparatur (19) zur Plasmafiltration aus dem Gesamtblut als auch besagter Apparatur (21) zur Dialyse des Gesamtbluts durch gereinigtes Plasma funktionell mit besagtem Leitungskanal (17) verbunden ist.
  3. Das Gerät zur Plasmareinigung gemäß Anspruch 2, dadurch gekennzeichnet, dass besagter Plasmareinigungskreislauf (23) eine Apparatur (25) zur Entfernung wasserlöslicher und dialysierbarer toxischer Moleküle umfasst, die allgemein zur Blutreinigung verwendet wird, aber auch zur Reinigung von Plasma verwendet wird, das von besagter Apparatur (19) zur Plasmafiltration aus dem Gesamtblut stammt.
  4. Das Gerät zur Plasmareinigung gemäß Anspruch 3, dadurch gekennzeichnet, dass besagte Apparatur (25) zur Entfernung wasserlöslicher und dialysierbarer toxischer Moleküle aus Modulen besteht, die Diffusionsprozesse wie zum Beispiel High-Flux-Dialyse, konvektiv-diffusive Prozesse, rein konvektive Prozesse und membranbasierte adsorptive Prozesse durchführen.
  5. Das Gerät zur Plasmareinigung gemäß Anspruch 4, dadurch gekennzeichnet, dass besagte Apparatur (25) zur Entfernung wasserlöslicher und dialysierbarer toxischer Moleküle einen Dialysator (26) umfasst, der mit einem Dialysatbehälter (27), einem Behälter (28) für gebrauchtes Dialysat und einem Infusatbehälter (29) funktionell verbunden ist.
  6. Das Gerät zur Plasmareinigung gemäß Anspruch 2 oder nachfolgender Ansprüche, dadurch gekennzeichnet, dass besagter Plasmareinigungskreislauf (23) ein adsorptives und/oder perfusives Reinigungsmodul (30) umfasst, das zur Reinigung von Plasma verwendet wird, das aus besagter Apparatur (25) zur Entfernung wasserlöslicher und dialysierbarer toxischer Moleküle stammt.
  7. Das Gerät zur Plasmareinigung gemäß Anspruch 6, dadurch gekennzeichnet, dass besagtes adsorptive und/oder perfusive Reinigungsmodul (30) eine oder mehrere Adsorptionssäulen und/oder eine oder mehrere Perfusionssäulen an Aktivkohle umfasst.
EP04726449A 2003-04-16 2004-04-08 Gerät für die plasmareinigung in kombination mit plasmaadsorption-perfusion durch verwendung eines trikompartiment-dialysators Expired - Lifetime EP1613372B1 (de)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IT2003PD000076A ITPD20030076A1 (it) 2003-04-16 2003-04-16 Macchina per plasma purificazione combinata a plasma adsorbimento-perfusione mediante utilizzo di dializzatore tricompartimentale
PCT/EP2004/003788 WO2004091694A1 (en) 2003-04-16 2004-04-08 Machine for plasma purification combined with plasma adsorption-perfusion by using a tricompartmental dialyzer

Publications (2)

Publication Number Publication Date
EP1613372A1 EP1613372A1 (de) 2006-01-11
EP1613372B1 true EP1613372B1 (de) 2009-03-11

Family

ID=29267081

Family Applications (1)

Application Number Title Priority Date Filing Date
EP04726449A Expired - Lifetime EP1613372B1 (de) 2003-04-16 2004-04-08 Gerät für die plasmareinigung in kombination mit plasmaadsorption-perfusion durch verwendung eines trikompartiment-dialysators

Country Status (6)

Country Link
US (1) US20060186044A1 (de)
EP (1) EP1613372B1 (de)
AT (1) ATE424866T1 (de)
DE (1) DE602004019900D1 (de)
IT (1) ITPD20030076A1 (de)
WO (1) WO2004091694A1 (de)

Families Citing this family (26)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102004054747A1 (de) * 2004-11-12 2006-05-24 Fresenius Medical Care Deutschland Gmbh Verfahren und Vorrichtung zur Abreicherung wenigstens einer Komponente eines fluiden Mediums
US20070125709A1 (en) * 2005-09-02 2007-06-07 Alok Nigam Extracorporeal Renal Dialysis System
WO2007046757A1 (en) * 2005-10-17 2007-04-26 Gambro Lundia Ab Extracorporeal blood cleaning
WO2008051994A2 (en) * 2006-10-23 2008-05-02 Arbios Systems, Inc. Fluid-conserving cascade hemofiltration
EP2002855B1 (de) 2007-06-14 2012-07-11 RenApta B.V. Künstliche Niere
US8202240B2 (en) * 2008-08-12 2012-06-19 Caridianbct, Inc. System and method for collecting plasma protein fractions from separated blood components
US8123713B2 (en) * 2008-08-12 2012-02-28 Caridian Bct, Inc. System and method for collecting plasma protein fractions from separated blood components
IT1396679B1 (it) * 2009-11-05 2012-12-14 Sandei Apparato per la aferesi selettiva, particolarmente per la rimozione selettiva di componenti del plasma, cellule, proteine ovvero leucociti dal sangue su paziente vivo
GB0921528D0 (en) * 2009-12-09 2010-01-27 Mast Carbon Internat Ltd Carbon and its use in blood cleansing applications
EP2380610B1 (de) * 2010-04-20 2014-05-07 Gambro Lundia AB Hohe Cut-off-Hämodialysemembran zur Verwendung bei Leberdialyse
US9713668B2 (en) * 2012-01-04 2017-07-25 Medtronic, Inc. Multi-staged filtration system for blood fluid removal
US10010663B2 (en) 2013-02-01 2018-07-03 Medtronic, Inc. Fluid circuit for delivery of renal replacement therapies
US9623164B2 (en) 2013-02-01 2017-04-18 Medtronic, Inc. Systems and methods for multifunctional volumetric fluid control
US10850016B2 (en) 2013-02-01 2020-12-01 Medtronic, Inc. Modular fluid therapy system having jumpered flow paths and systems and methods for cleaning and disinfection
US9144640B2 (en) 2013-02-02 2015-09-29 Medtronic, Inc. Sorbent cartridge configurations for improved dialysate regeneration
US10098993B2 (en) 2014-12-10 2018-10-16 Medtronic, Inc. Sensing and storage system for fluid balance
US10874787B2 (en) 2014-12-10 2020-12-29 Medtronic, Inc. Degassing system for dialysis
US9713665B2 (en) 2014-12-10 2017-07-25 Medtronic, Inc. Degassing system for dialysis
JP2018509994A (ja) * 2015-03-27 2018-04-12 エリアス・セラピューティクス・インコーポレイテッドＥｌｉａｚ Ｔｈｅｒａｐｅｕｔｉｃｓ，Ｉｎｃ． 患者選択的アフェレシス
TWI627991B (zh) * 2016-09-14 2018-07-01 財團法人工業技術研究院 自驅式微流體過濾裝置、微流體過濾裝置及微流體驅動裝置
US11278654B2 (en) 2017-12-07 2022-03-22 Medtronic, Inc. Pneumatic manifold for a dialysis system
CN108211032B (zh) * 2018-02-01 2023-11-17 南方医科大学珠江医院 组合型生物人工肝支持系统
US11033667B2 (en) 2018-02-02 2021-06-15 Medtronic, Inc. Sorbent manifold for a dialysis system
US11110215B2 (en) 2018-02-23 2021-09-07 Medtronic, Inc. Degasser and vent manifolds for dialysis
EP3833608A4 (de) 2018-08-06 2022-04-27 Graphic Packaging International, LLC Behälter mit mindestens einem fach
CN112755288B (zh) * 2020-12-21 2022-06-14 山东壹瑞特生物科技有限公司 一种体外肝脏支持系统

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2231421B1 (de) * 1973-05-30 1976-05-07 Rhone Poulenc Ind
US4340481A (en) * 1975-02-15 1982-07-20 Asahi Kasei Kogyo Kabushiki Membrane filtration type hollow fibers
US4209392A (en) * 1978-05-15 1980-06-24 Wallace Richard A Portable hepatic-assist method and apparatus for same
DE3101159C2 (de) * 1981-01-16 1985-08-22 Udipi Ramakrishna Dr. 5100 Aachen Shettigar Verfahren zur Reinigung von Blut und künstliche Niere zur Durchführung des Verfahrens
JPS6045359A (ja) * 1983-08-19 1985-03-11 鐘淵化学工業株式会社 血液浄化器
US4663049A (en) * 1984-07-05 1987-05-05 University Of Utah Process for therapeutic dissociation of immune complexes and removal of antigens
DE4102693A1 (de) * 1991-01-30 1992-08-06 Schurek Hans Joachim Prof Dr M Verfahren und einrichtung zur haemofiltratdialyse

Also Published As

Publication number Publication date
WO2004091694A1 (en) 2004-10-28
ITPD20030076A1 (it) 2003-07-15
DE602004019900D1 (de) 2009-04-23
US20060186044A1 (en) 2006-08-24
EP1613372A1 (de) 2006-01-11
ATE424866T1 (de) 2009-03-15

Similar Documents

Publication Publication Date Title
EP1613372B1 (de) Gerät für die plasmareinigung in kombination mit plasmaadsorption-perfusion durch verwendung eines trikompartiment-dialysators
US5858238A (en) Salvage of autologous blood via selective membrane/sorption technologies
Rifai et al. Prometheus®–a new extracorporeal system for the treatment of liver failure☆
US9713668B2 (en) Multi-staged filtration system for blood fluid removal
US11478757B2 (en) High cut-off hemodialysis membrane for use in liver dialysis
US20150273127A1 (en) Liver support system
Krisper et al. Clearing of toxic substances: are there differences between the available liver support devices?
Santoro et al. Liver support systems
EP1765433A1 (de) Plasmaentgiftung und volumensteuerungssystem sowie anwendungsverfahren
EP2076297A2 (de) Flüssigkeitsbewahrende kaskadierende hämofiltration
CN111315424A (zh) 使用包含组合的中空纤维过滤器模块和聚合物吸着剂的体外回路从血液去除毒素的方法
Santoro et al. Prometheus system: a technological support in liver failure
US9950103B2 (en) Combination kidney and liver dialysis system and method
US20190328952A1 (en) Multi-stage blood purification apparatus for removal of toxins
Nalesso Plasma filtration adsorption dialysis (PFAD): a new technology for blood purification
Nalesso et al. Albumin dialysis and plasma filtration adsorption dialysis system
CN203354984U (zh) 配备方形储浆池的血浆置换吸附滤过净化系统
JP3257613B2 (ja) 血液透析装置の透析液管理装置
Abe et al. Extracorporeal albumin dialysis
JP4201313B2 (ja) 有害物質結合アルブミン除去システム
Lee et al. Development of a multifunctional detoxifying unit for liver failure patients
EP3024510A1 (de) Blutreinigungssysteme und vorrichtungen mit intern generierter ersatzflüssigkeit
Ralli et al. Purifying capacity of a new membrane characterized by a medium cut-off and high performance
George Artificial liver support systems
CN111529784B (zh) 一种cpfa搭桥管路

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

17P Request for examination filed

Effective date: 20051007

AK Designated contracting states

Kind code of ref document: A1

Designated state(s): AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IT LI LU MC NL PL PT RO SE SI SK TR

AX Request for extension of the european patent

Extension state: AL HR LT LV MK

DAX Request for extension of the european patent (deleted)
17Q First examination report despatched

Effective date: 20071108

GRAP Despatch of communication of intention to grant a patent

Free format text: ORIGINAL CODE: EPIDOSNIGR1

GRAS Grant fee paid

Free format text: ORIGINAL CODE: EPIDOSNIGR3

GRAA (expected) grant

Free format text: ORIGINAL CODE: 0009210

AK Designated contracting states

Kind code of ref document: B1

Designated state(s): AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IT LI LU MC NL PL PT RO SE SI SK TR

REG Reference to a national code

Ref country code: GB

Ref legal event code: FG4D

REG Reference to a national code

Ref country code: CH

Ref legal event code: EP

REG Reference to a national code

Ref country code: IE

Ref legal event code: FG4D

REF Corresponds to:

Ref document number: 602004019900

Country of ref document: DE

Date of ref document: 20090423

Kind code of ref document: P

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: SI

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

Ref country code: NL

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

Ref country code: FI

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

NLV1 Nl: lapsed or annulled due to failure to fulfill the requirements of art. 29p and 29m of the patents act
PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: AT

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

Ref country code: SE

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090611

Ref country code: PL

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: BE

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: ES

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090622

Ref country code: PT

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090824

Ref country code: CZ

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

Ref country code: EE

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: SK

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

Ref country code: RO

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

REG Reference to a national code

Ref country code: CH

Ref legal event code: PL

PLBE No opposition filed within time limit

Free format text: ORIGINAL CODE: 0009261

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: NO OPPOSITION FILED WITHIN TIME LIMIT

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: DK

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

Ref country code: BG

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090611

Ref country code: LI

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20090430

Ref country code: CH

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20090430

26N No opposition filed

Effective date: 20091214

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: MC

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20090430

Ref country code: IE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20090408

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: GR

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090612

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: LU

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20090408

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: HU

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090912

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: TR

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: CY

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20090311

REG Reference to a national code

Ref country code: DE

Ref legal event code: R082

Ref document number: 602004019900

Country of ref document: DE

Representative=s name: WINTER, BRANDL, FUERNISS, HUEBNER, ROESS, KAIS, DE

REG Reference to a national code

Ref country code: FR

Ref legal event code: PLFP

Year of fee payment: 12

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: DE

Payment date: 20150422

Year of fee payment: 12

Ref country code: GB

Payment date: 20150423

Year of fee payment: 12

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: IT

Payment date: 20150429

Year of fee payment: 12

Ref country code: FR

Payment date: 20150422

Year of fee payment: 12

REG Reference to a national code

Ref country code: DE

Ref legal event code: R119

Ref document number: 602004019900

Country of ref document: DE

GBPC Gb: european patent ceased through non-payment of renewal fee

Effective date: 20160408

REG Reference to a national code

Ref country code: FR

Ref legal event code: ST

Effective date: 20161230

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: FR

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20160502

Ref country code: GB

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20160408

Ref country code: DE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20161101

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: IT

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20160408